Kimberly Ann Kernehan, MS-CAT, CASAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Alexandria Bay, NY

NPI 1376904649 · NPPES record last updated Mar 15, 2016

Key facts

NPI
1376904649
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
32047 (NY)
Practice address
4 Fuller St
Alexandria Bay, NY 13607-1316
Phone
(315) 482-1290
NPI assigned
Mar 15, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
32047NYMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 32047 NY Yes

Addresses

Primary practice location

4 Fuller St
Alexandria Bay, NY 13607-1316

Mailing address

164 Dennison Rd
Massena, NY 13662-3223
Phone (315) 482-1290

Other providers in Alexandria Bay, NY

All providers in Alexandria Bay, NY · Addiction (Substance Use Disorder) Counselor in New York

Sources for this page

Verify at the official NPI Registry.